Reviewer Feedback for Abstract Submissions to the Pediatric Academic Societies Meeting: A Pilot Project.

Purpose: To describe and evaluate a pilot project to provide reviewer comments to authors who submitted abstracts to the Hospital-based medicine topic area for the Pediatric Academic Societies (PAS) 2021 annual meeting METHODS: Abstract reviewers were encouraged via email to include reviewer comments for authors in their abstract reviews. Unedited comments were emailed to authors shortly after the abstract decision notifications were sent. We quantified the number of reviewers who commented per abstract.

A Quality Improvement Approach to Decreasing Postdischarge Acute Care Reuse Among Children With Asthma.

Objectives: To reduce 7-day acute care reuse among children with asthma after discharge from an academic children's hospital by standardizing the delivery of clinical care and patient education.

Methods: A diverse group of stakeholders from our tertiary care children's hospital and local community agencies used quality improvement methods to implement a series of interventions within inpatient, emergency department (ED), and outpatient settings. These interventions were designed to improve admission, inpatient care, and discharge processes for children hospitalized because of asthma and included a focus on (1) resident education, (2) patient access to medication and asthma education, and (3) gaps in existing asthma clinical care pathways in the ED and ICU.

Association Between Physician Risk Assessment, Hierarchical Condition Categories, and Utilization of Medical Services.

Hierarchical Condition Categories (HCCs) are a common risk adjustment tool that may support alignment of care management resources with the clinical needs of a population. The authors examined the association between HCC scores and physician-determined clinical risk (CR) scores, annual charges, and utilization of medical care. CR score was defined as the anticipated risk for "ED or a hospital admission" within the following year.

Caregiver Perspectives on Communication During Hospitalization at an Academic Pediatric Institution: A Qualitative Study.

Objective: Communication among those involved in a child's care during hospitalization can mitigate or exacerbate family stress and confusion. As part of a broader qualitative study, we present an in-depth understanding of communication issues experienced by families during their child's hospitalization and during the transition to home.

Methods: Focus groups and individual interviews stratified by socioeconomic status included caregivers of children recently discharged from a children's hospital after acute illnesses.

Optimizing a Nurse-led Transitional Home Visit Program in Preparation for a Randomized Control Trial.

Introduction: The Hospital to Home Outcomes study began with the end goal of evaluating the effectiveness of a single, nurse-led transitional home visit (home visit) program, for acutely ill, pediatric patients, which had been piloted at our institution. As part of the overall study design, building on prior randomized control trials that utilized a run-in period prior to the trial, our study team designed an optimization period to test the home visit and study procedures under real-world conditions.

Methods: For this optimization project, there were 3 process improvement goals: to improve the referral process to the home visit, to optimize the home visit content, and to define and operationalize measures of patient- and family-centered outcomes to be used in the subsequent randomized control trial.

Socioeconomic status influences the toll paediatric hospitalisations take on families: a qualitative study.

Background: Stress caused by hospitalisations and transition periods can place patients at a heightened risk for adverse health outcomes. Additionally, hospitalisations and transitions to home may be experienced in different ways by families with different resources and support systems. Such differences may perpetuate postdischarge disparities.

Communication Challenges: A Qualitative Look at the Relationship Between Pediatric Hospitalists and Primary Care Providers.

Objective: Primary care providers (PCPs) and hospitalists endorse the importance of effective communication yet studies illustrate critical communication problems between these 2 provider types. Our objective was to develop deeper insight into the dimensions of and underlying reasons for communication issues and determine ways to improve communication and remove barriers by eliciting the perspectives of pediatric PCPs and hospitalists.

Methods: Using qualitative methods, 2 sets of focus groups were held: 1) mix of local PCPs serving diverse populations, and 2) hospitalists from a free-standing, pediatric institution.

Testing a post-discharge nurse-led transitional home visit in acute care pediatrics: the Hospital-To-Home Outcomes (H2O) study protocol.

Aims: The aims of this study were: (1) to explore the family perspective on pediatric hospital-to-home transitions; (2) to modify an existing nurse-delivered transitional home visit to better meet family needs; (3) to study the effectiveness of the modified visit for reducing healthcare re-use and improving patient- and family-centered outcomes in a randomized controlled trial.

Background: The transition from impatient hospitalization to outpatient care is a vulnerable time for children and their families; children are at risk for poor outcomes that may be mitigated by interventions to address transition difficulties. It is unknown if an effective adult transition intervention, a nurse home visit, improves postdischarge outcomes for children hospitalized with common conditions.

The Family Perspective on Hospital to Home Transitions: A Qualitative Study.

Background And Objective: Transitions from the hospital to home can be difficult for patients and families. Family-informed characterization of this vulnerable period may facilitate the identification of interventions to improve transitions home. Our objective was to develop a comprehensive understanding of hospital-to-home transitions from the family perspective.

Changes in medical errors after implementation of a handoff program.

Background: Miscommunications are a leading cause of serious medical errors. Data from multicenter studies assessing programs designed to improve handoff of information about patient care are lacking.

Methods: We conducted a prospective intervention study of a resident handoff-improvement program in nine hospitals, measuring rates of medical errors, preventable adverse events, and miscommunications, as well as resident workflow.

Multidisciplinary handoffs improve perceptions of communication.

Background: Communication errors during handoffs are a leading cause of sentinel events. The Accreditation Council for Graduate Medical Education 2011 duty hour standards (DHS) increase the frequency of handoffs.

Objective: The goal of this study was to determine if a multidisciplinary group handoff bundle improves communication while working within the 2011 DHS.

Pediatric hospitalist perceptions of the impact of duty hour changes on education and patient care.

Objective: The goal of this study was to measure the impact of the new 2011 Accreditation Council for Graduate Medical Education duty hour standards (DHS) on education, patient care, and overall satisfaction as perceived by pediatric hospitalist faculty.

Methods: We undertook a nonrandomized but controlled study of 23 pediatric hospitalist faculty members during a trial of the new DHS in 2011. During the intervention (January), residents piloted schedules that complied with the new DHS, and in the control period (February), resident schedules complied with previous DHS.

A collaborative system to improve compartment syndrome recognition.

Background And Objective: Acute compartment syndrome (ACS) is a rare but serious complication of extremity injury that can cause permanent damage or death. ACS development is variable and unpredictable, and delay in recognition or treatment of ACS can lead to significant morbidity. Our objective was to create a reliable system for recognition of patients at risk and monitoring for ACS that could withstand frequent provider turnover.

Watch and learn: an innovative video trigger curriculum to increase resident screening for social determinants of health.

Objective: To determine the effectiveness of an innovative curriculum, using trigger videos modeling screening for social determinants of health (SDH), on the comfort and screening practices of pediatric residents during well-child care.

Methods: A nonrandomized controlled study of an educational intervention was performed. Resident surveys assessing knowledge, comfort, and screening practices for SDH were performed pre- and post-intervention.

Resident confidence addressing social history: is it influenced by availability of social and legal resources?

Background: Pediatric residency clinics caring for underserved populations are often staffed with varying levels of social and legal resources, though their effects on residents' knowledge and practice have not been studied. Aim To examine the effects of clinic-based social and legal resources on resident knowledge and screening patterns for social determinants of health.

Methods: A cross-sectional study of residents from 3 continuity clinics with different social and legal resources was performed.

Utilizing improvement science methods to improve physician compliance with proper hand hygiene.

Objective: In 2009, The Joint Commission challenged hospitals to reduce the risk of health care-associated infections through hand hygiene compliance. At our hospital, physicians had lower compliance rates than other health care workers, just 68% on general pediatric units. We used improvement methods and reliability science to increase compliance with proper hand hygiene to >95% by inpatient general pediatric teams.